The novel epitomizes many of Dick's themes with its concerns about the nature of reality and ordinary people in ordinary lives having the world unravel around them. The title is a reference to the line uttered by Hamlet to Horatio after being visited by his father's ghost and learning that his uncle Claudius murdered his father; in short, a shocking supernatural event that fundamentally alters the way Hamlet perceives the state and the universe ("The time is out of joint; O cursed spite!/That ever I was born to set it right!" [I.V.211-2]), much as do several events in the novel.

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As the novel opens, its protagonist Ragle Gumm believes that he lives in the year 1959 in a quiet American suburb. His unusual profession consists of repeatedly winning the cash prize in a local newspaper competition called, "Where Will The Little Green Man Be Next?". Gumm's 1959 has some differences from ours: the Tucker car is in production, AM/FM radios are scarce to non-existent and Marilyn Monroe is a complete unknown. As the novel opens, strange things begin to happen to Gumm. A soft-drink stand disappears, replaced by a small slip of paper with the words "SOFT-DRINK STAND" printed on it in block letters. Intriguing little pieces of the real 1959 turn up: a magazine article on Marilyn Monroe, a telephone book with non-operational exchanges listed and radios hidden away in someone else's house. People with no apparent connection to Gumm, including military pilots using aircraft transceivers, refer to him by name. Few other characters notice these or experience similar anomalies; the sole exception is Gumm's supposed brother-in-law, Victor "Vic" Nielson, in whom he confides. A neighborhood woman, Mrs. Keitelbein, invites him to a Civil Defense class where he sees a model of a futuristic underground military factory. He has the unshakeable feeling he's been inside that building many times before.

Confusion gradually mounts for Gumm. His neighbor Bill Black knows far more about these events than he admits, and, observing this, begins worrying: "Suppose Ragle [Gumm] is becoming sane again?" In fact, Gumm does become sane, and the deception surrounding him (erected to protect and exploit him) begins to unravel.

Gumm tries to escape the town and is turned back by kafkaesque obstructions. He sees a magazine with himself on the cover, in a military uniform, at the factory depicted in the model. He tries a second time to escape, this time with Vic, and succeeds. He learns that his idyllic town is a constructed reality designed to protect him from the frightening fact that he lives on a then-future Earth (circa 1998) that is at war against Lunar colonists who are fighting for a permanent Lunar settlement, politically independent from Earth.

Gumm has a unique ability to predict where the colonists' nuclear strikes will be aimed. Previously Gumm did this work for the military, but then he defected to the colonists' side and planned to secretly emigrate to the Moon. But before this could happen he began retreating into a fantasy world based largely upon the relatively idyllic surroundings of his extreme youth. He was no longer able to shoulder his responsibility as Earth's lone protector from Lunar-launched nuclear offensives. The fake town was thereby created within Gumm's mind to accommodate and rationalise his dementia so that he could continue predicting nuclear strikes in the guise of submitting entries to a harmless newspaper contest and without the ethical qualms involved with being on the "wrong" side of a civil war.

When Gumm finally remembers his true personal history, he decides to emigrate to the Moon after all because he feels that exploration and migration, as basic human impulses, should never be denied to people by any national or planetary government. Vic rejects this belief, referring to the colonists essentially as aggressors and terrorists, and returns to the simulated town- which has lost its raison d'etre because of Gumm's escape from its environs. The book ends with some hope for peace, because the Lunar colonists are more willing to negotiate than Earth's "One Happy World" regime has been telling its citizens.